Urodynamic findings, bladder emptying methods and therapeutic approaches in patients with upper lumbar and lower lumbar-sacral spinal cord injury.

ABSTRACT

There have been previous reports of both demographic and clinical features with urodynamic evaluation results of patients with traumatic spinal cord injury (SCI). These studies were conducted on patients with cervical and thoracal SCI, but there has been no comparative study evaluating the urodynamic outcomes of patients with lumbosacral SCI. Therefore, it was aimed to investigate the bladder features and treatment options in patients with lumbosacral SCI to be able to take appropriate therapeutic decisions. The urodynamic data of 121 patients with lumbar and sacral SCI were obtained retrospectively using the urodynamics unit records. The patients were grouped as upper lumbar (L1 and L2) SCI (ULSCI) and lower lumbar-sacral (L3 to S5) SCI (LLSSCI). The patients were 92 males (76 %) and 29 (24 %) females, comprising 74 (61.2 %) ULSCI patients and 47 (38.8 %) LLSSCI patients. Detrusor hypocompliancy and anticholinergic prescription were more frequent in the ULSCI group than in the LLSSCI group, while alpha-blocker prescription was more frequent in the LLSSCI group than in the ULSCI group. There was a statistically significant difference between the groups in respect of the rates of bladder-emptying method on admission. A higher mean micturated urine volume was observed in the LLSSCI group than in the ULSCI group. The rates of bladder-filling sensation, detrusor overactivity, bladder-storage and emptying disorders, prescribed emptying method, and residual urine volume were similar in both groups. These results showed that there are differences in neurogenic bladder features and treatment options for patients with upper lumbar and lower lumbar-sacral SCI.